The prevalence of general and abdominal obesity according to sasang constitution in Korea

Physiopathology and Treatment of Obesity and Overweight: A Proposal for a New Anorectic

The "new epidemic," as WHO calls obesity, is caused by overeating, which, having exceeded the body's actual needs, accumulates in the form of health-damaging fat deposits. Moving more and eating less is the main remedy, but eating belongs to vital instincts, which are beyond the control of reason. In this sense, eating is different from drinking and breathing because without food it is possible to survive for a few weeks, without water for a few days, without oxygen for a few minutes. The first part of this article provides an overview of obesity and its treatment, focusing on the new anorectic anticipated in the title. The second part focuses on compulsive obesity, typically represented by constitutional obesity and food addiction. The article concludes with a discussion of the pharmacological treatment of compulsive diseases, to which some forms of obesity belong.

Resting Metabolic Rate for Diagnosing Tae-Eum Sasang Type and Unraveling the Mechanism of Type-Specific Obesity

Increased resting metabolic rate (RMR), representing augmented energy expenditure, is a preferred physical characteristic; however, the Tae-Eum Sasang type, with a high incidence of obesity and metabolic diseases, has a higher RMR. This study scrutinized the physical characteristics of Sasang typology, a traditional Korean personalized medicine, to resolve this discrepancy, which can unravel the mechanism of Tae-Eum-type-specific obesity and improve the Tae-Eum Sasang-type diagnosis. A total of 395 healthy participants provided Sasang-type diagnosis using Sasang Constitutional Analysis Tool and physical features, including skeletal muscle mass, body fat mass, and RMR, along with those standardized using body weight. The Tae-Eum-type group showed significantly higher body weight, body mass index, body fat mass, and unstandardized RMR (kcal/day) than others, while their standardized measures of RMR per weigh (RMRw, kcal/day/kg) and percent skeletal muscle (PSM, %) were significantly lower. The logistic regression model revealed that the RMRw is pivotal for discriminating Tae-Eum type from others and explaining the developmental mechanism of Tae-Eum-type obesity. The aforementioned might provide a theoretical framework for Sasang-type diagnosis and Sasang-type-specific health promotion using bodily exercise and medical herbs.

Sasang Constitution Type Combined with General Obesity May Act as a Risk Factor for Prediabetes Mellitus

Sasang constitutional medicine is a traditional customized medicine in Korea that classifies people into four types: Taeeumin (TE), Taeyangin (TY), Soeumin (SE), and Soyangin (SY). This study explored whether Sasang constitution (SC) types combined with general obesity could be risk factors for prediabetes mellitus (pre-DM). This study was cross-sectional and was conducted from November 2007 to July 2011 in 23 Korean medical clinics. In total, 2185 eligible subjects participated. A t test, one-way ANOVA with Scheffé’s post hoc analysis, the chi-square test and multinomial logistic regression were used. Significance was indicated by p < 0.05. The numbers of participants with normal fasting plasma glucose (FPG) levels and pre-DM were 405 (75.3%) and 133 (24.7%) in the SE, 516 (70.3%) and 218 (29.7%) in the SY, and 590 (64.6%) and 323 (35.4%) in the TE (p < 0.001) groups, respectively. There was a significant difference in the proportion of each SC type among people with pre-DM and normal FPG levels in the normal BMI group. The odds ratios (ORs) of the TE type were significantly different from those of the SE type in the crude and Model 1. The distribution of the normal FPG and pre-DM individuals between the obese and normal BMI groups only for the SY type was significantly different. The SY type combined with general obesity had a higher OR (1.846, 95% CI 1.286−2.649) than that combined with normal BMI among participants with pre-DM, and this higher OR remained after adjusting for covariates (OR, 1.604, 95% CI, 1.093−2.354). This study revealed that the TE type might be a risk factor for pre-DM in the normal BMI group, and the SY type with general obesity could be a risk factor for pre-DM compared with the SY type with normal BMI. Accordingly, SC and BMI should be considered when managing pre-DM. To clarify the risk of SC and BMI, further study including epigenetic factors is needed.

Exploratory Analysis of the Sasang Constitution by Combining Network Analysis and Information Entropy

Sasang constitutional medicine is a unique concept in Korean medicine that can provide valuable insights into personalized healthcare and disease treatment. In this study, we combined network analysis and information entropy to systematically investigate the related information of Sasang constitutional (SC) types. A feature network was constructed using SC type and clinical information. The SC type-associated features and feature classes were identified using statistical analysis and entropy ranking. The patient network was constructed based on SC-type-associated features. We found that the feature network was closely connected within the features of the same classes and between several feature class pairs, including the symptom class. Most of the separation values between the feature classes, including the symptom class, were negative. In addition, we found 42 clinical features related to the SC type, and two important classes -personality and cold/heat- that increase the entropy ranking of the SC type. In the patient network, we found sparsely connected modules between SC types and a positive separation value between the Taeeumin–Soeumin and Taeeumin–Soyangin pairs. Our data-driven approach provides a deeper understanding of modernized forms of SC types and suggests that SC type is a practically useful concept for stratified healthcare and personalized medicine.

Prevalence of abdominal obesity and associated risk factors among women civil servants in Addis Ababa, Ethiopia, 2021: an institution-based study

Background

Abdominal obesity increases the risk of cardio-metabolic diseases, disability, and poor quality of life, as well as health-care costs. It is a component of the metabolic syndrome, along with hypertension, diabetes, and dyslipidemia. The goal of this study was to determine the prevalence of abdominal obesity and associated risk factors among female civil servants in Addis Ababa, Ethiopia in 2021.

Methods

An institution-based cross-sectional study was undertaken from March31^st to April 15^th, 2021.A multi-stage sampling technique was employed to select 478 study participants. Data was entered into EpiData version 3.1 and then exported to SPSS version 21 for analysis. A descriptive data analysis was used to present the distribution of study variables. Bivariable and multivariable analyses were used to assess the relationship between independent variables and abdominal obesity at 95% CI. The level of statistical significance was declared at a p-value less than 0.05.

Result

The prevalence of abdominal obesity defined by waist circumference was found to be29.5% (95% CI: 25.39-33.6%) and 32.8% (95% CI: 28.57%-37.03%) by waist hip ratio, respectively. Age group 29-37 years [AOR= 2.451, 95% CI: (1.199-5.013)], age group 38-46 years [AOR=3.807, 95% CI: (1.328-10.914)], age group 47-55 years [AOR=6.489, 95% CI: (1.367-30.805)], being married [AOR= 4.762, 95% CI: (2.321-9.721)],consumption of meat >=5 per week[ AOR= 4.764, 95% CI: (1.939-11.711)], having lunch daily[AOR= 0.388, 95% CI:(0.166-0.910)] and snack consumption [AOR=4.163, 95% CI:(1.503-11.534)] were significantly associated with abdominal obesity.

Conclusion

The prevalence of abdominal obesity as measured by waist circumference and waist hip ratio was found to be moderate and high, respectively. Age, being married, high consumption of meat, and having lunch daily were identified as associated with abdominal obesity. Healthy diet health education and nutrition intervention should be considered, with a focus on married, meat-consuming, and older age-group female civil servants.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-022-00613-9.

A full pipeline of diagnosis and prognosis the risk of chronic diseases using deep learning and Shapley values: The Ravansar county anthropometric cohort study

Anthropometry is a Greek word that consists of the two words “Anthropo” meaning human species and “metery” meaning measurement. It is a science that deals with the size of the body including the dimensions of different parts, the field of motion and the strength of the muscles of the body. Specific individual dimensions such as heights, widths, depths, distances, environments and curvatures are usually measured. In this article, we investigate the anthropometric characteristics of patients with chronic diseases (diabetes, hypertension, cardiovascular disease, heart attacks and strokes) and find the factors affecting these diseases and the extent of the impact of each to make the necessary planning. We have focused on cohort studies for 10047 qualified participants from Ravansar County. Machine learning provides opportunities to improve discrimination through the analysis of complex interactions between broad variables. Among the chronic diseases in this cohort study, we have used three deep neural network models for diagnosis and prognosis of the risk of type 2 diabetes mellitus (T2DM) as a case study. Usually in Artificial Intelligence for medicine tasks, Imbalanced data is an important issue in learning and ignoring that leads to false evaluation results. Also, the accuracy evaluation criterion was not appropriate for this task, because a simple model that is labeling all samples negatively has high accuracy. So, the evaluation criteria of precession, recall, AUC, and AUPRC were considered. Then, the importance of variables in general was examined to determine which features are more important in the risk of T2DM. Finally, personality feature was added, in which individual feature importance was examined. Performing by Shapley Values, the model is tuned for each patient so that it can be used for prognosis of T2DM risk for that patient. In this paper, we have focused and implemented a full pipeline of Data Creation, Data Preprocessing, Handling Imbalanced Data, Deep Learning model, true Evaluation method, Feature Importance and Individual Feature Importance. Through the results, the pipeline demonstrated competence in improving the Diagnosis and Prognosis the risk of T2DM with personalization capability.

Relationship between Low Vegetable Consumption, Increased High-Sensitive C-Reactive Protein Level, and Cardiometabolic Risk in Korean Adults with Tae-Eumin: A Cross-Sectional Study

An anti-inflammatory diet has many beneficial effects on cardiometabolic diseases. Constitution type of traditional Korean medicine can predict cardiometabolic risk factors. We examined the relationship between vegetable consumption and the high-sensitive C-reactive protein (hs-CRP) level on cardiometabolic risk factors in Korean adults by constitution types. Data from 1,983 eligible participants (mean age, 44.3 years) were included in the present cross-sectional study. The inflammatory status of the participants was categorized into low- (<3.0 mg/L) or high-risk (≥3.0 mg/L) groups based on their constitution types. Cardiometabolic risk factors (abdominal obesity, elevated triglycerides, reduced high-density lipoprotein-cholesterol, elevated blood pressure, elevated fasting plasma glucose, and ≥2 concurrent cardiovascular diseases (CVDs) risk factors) and dietary assessment of the participants were assessed. A total of 11.1% of Tae-eumin (TE) and 4.9% of non-TE groups had a higher hs-CRP level (TE: 6.6 ± 0.2, non-TE: 8.4 ± 0.3) than a low hs-CRP level TE and non-TE (TE: 0.9 ± 0.1, non-TE: 0.6 ± 0.1). Vegetable consumption of <91.5 g/day was highly associated with a high-risk hs-CRP level (adjusted odds ratio (ORs): second tertile (T2): 2.290, (95% confidence interval (CI): 1.285-4.082); first tertile (T1): 2.474 (95% CI: 1.368-4.475), P=0.003) compared with that of the highest (T3) in TE. Low (T1 and T2) vegetable consumption was associated with a 54-63% increased prevalence of more than two concurrent CVDs risk factors compared with that of the highest in the TE group (P=0.012). Higher vegetable consumption greatly decreased the prevalence of CVDs risk factors by 63-86% in the low-risk and high-risk hs-CRP TE groups. Our results highlight the cardioprotective effects of higher consumption of vegetables in Korean adults with TE. Evidence-based clinical risk factor management and multifaceted approaches at the community and population levels targeting prevention in high-burden groups are recommended to reduce the premature mortality attributed to CVD.

Qualitative study on the key elements of obesity counseling in Korean Medicine

INTRODUCTION

The increasing prevalence of obesity worldwide necessitates the provision of support for many patients. Patients with obesity appreciate receiving advice from doctors. Previous studies have qualitatively explored clinicians' counseling for weight loss; however, this is limited to primary physicians or general practitioners working in community health centers. In contrast, Korean Medicine Doctors (KMDs) have treated patients with obesity using a holistic approach with a multicomponent approach on counseling. However, there is currently no data regarding KMDs' consulting practices for weight loss. Therefore, the present study will explore KMDs' experience in counseling for weight loss and describe the constituents of counseling for weight loss in Korean medicine practice.

METHODS

This qualitative study utilizes a phenomenological framework. The KMDs who have worked >1 year as practitioners in treating patients with obesity will be invited to describe their lived experiences of counseling patients for weight loss. Purposive and snowball sampling will be undertaken to ensure that the sample provides information-rich cases that are representative of KMDs' experiences of counseling for weight loss. Face-to-face, individual, and semi-structured interviews will be conducted with the participants, which will be analyzed using a phenomenological method.

ETHICS AND DISSEMINATION

Ethical approval was granted by the Human Research Ethics Committee of the Korea Institute of Oriental Medicine (I-1908/006-001). The results will be disseminated via journal articles and conference presentations.

TRIAL REGISTRATION NUMBER

Korean Clinical Trial Registry, KCT0004985.

Analysis of the bio-psychological characteristics of Sasang typology in Korean preschool children using the ponderal index and the temperament and character inventory

OBJECTIVES

The aim of this study was to identify different physical and mental characteristics among three common Sasang types, Tae-eum, So-yang, and So-eum (except scarce type, Tae-Yang) in preschoolers, to improve constitutional diagnoses.

METHODS

Our study included 65 boys and 67 girls from six kindergartens in South Korea. The number of children who were categorized as Tae-Yang, Tae-Eum, So-Yang, and So-Eum types were 1, 56, 40, and 35, respectively. We measured height, weight, mid-parental height, predicted adult height, ponderal index (PI), and findings from the junior temperament and character inventory 3 to 6.

RESULTS

The Tae-eum type exhibited higher weight percentiles and PIs than the other types (p < 0.001), and the So-eum type displayed higher harm avoidance (HA) scores than the Tae-eum type (p = 0.033).

CONCLUSIONS

Children with high PIs and low HA scores have a higher probability of being classified as the Tae-eum type than as the So-eum type.

Traditional Korean Medicine-Based Forest Therapy Programs Providing Electrophysiological Benefits for Elderly Individuals

We aimed to develop forest therapy programs (FTPs) to prevent dementia and related health problems in the elderly population, with the assumption that health benefits are FTP-type specific and depend on the participant's psychophysiological traits. For this purpose, we developed two distinct FTPs, namely, a guided-breathing meditation program (BP) and a walking program (WP); we adopted the approach of Sasang constitutional (SC) medicine, which categorizes individuals into one of three SC types (SC1, SC2, or SC3) for medical care. The FTPs ran 11 sessions over 11 weeks. We recruited 29/31/28 participants who were 65 years of age or older for the BP/WP/control groups, respectively; obtained electrophysiological measurements via electroencephalogram (EEG), heart rate variability (HRV), and bioimpedance; and analyzed the intervention effects with analysis of covariance. Compared with the control, the BP and WP resulted in benefits for neural activity and parasympathetic nervous activity (PNA), respectively, and both FTPs yielded distinct beneficial effects on bioimpedance. Constitution-specific effects were also present. The SC1- and SC2-type participants gained positive effects in neural activity from the BP and WP, respectively. The SC3-type participants showed improvements in PNA from the WP. In conclusion, for older individuals, both programs conferred health benefits that would help prevent dementia, and the benefits were program-specific and constitution-specific.

Research trends in Korean medicine based on temporal and network analysis

Background

Much research on Korean medicine has been recently published in Korea. The aim of this study was to determine the research trends in Korean medicine by performing a comprehensive analysis of articles that have been published in Korea using temporal and network analysis methods.

Methods

A total of 29,876 articles from 1963 to 2018 were prepared from OASIS (Oriental Medicine Advanced Searching Integrated System), the largest portal for Korean medicine. After the keywords and years were extracted from the metadata of the articles, an annual frequency matrix was obtained for the keywords. By using the matrix, the temporal trends of the keywords were analyzed by comparing the changes in similarity between the lists of keywords by year. Moreover, to analyze the relationship among research topics, a clustered network was constructed in which a node was a keyword and an edge was a similarity between two keywords.

Results

The temporal trend of the keywords was classified into six chronological phases. The appearance frequency of most keywords tended to increase gradually, but only the keywords “mibyeong,” “systems biology” and “korean medicine hospital” appeared in the most recent phase. The network of keywords was clustered and visualized into thirteen groups with the Gephi software. The main keywords in each group were related to effects such as “anti-inflammation” and “antioxidant,” to diseases such as “allergic rhinitis” and “diabetes” and to therapies such as “herbal acupuncture” and “herbal formula.”

Conclusions

The analysis of the trends determined in this study provides a systematic understanding as well as future research directions in Korean medicine to researchers. In the future, an overall analysis of the research trends in Korean medicine will be done by analyzing articles published in Korea and other countries.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2562-0) contains supplementary material, which is available to authorized users.

Genetic and Environmental Overlaps Among Sasang Constitution Types: A Multivariate Twin Study

According to the Sasang theory, humans can be categorized into one of the four Sasang constitution (SC) types. The four SC types are Tae-Yang (TY), Tae-Eum (TE), So-Yang (SY), and So-Eum (SE), which are determined mainly on the basis of anthropometric characteristics, personality, and the balance of the physiological functions of the major organ systems. There is a growing recognition in the complementary and alternative medicine area that SC types have the potential to be a useful scientific tool for the prevention, diagnosis, and treatment of diseases (Cooper, Evidence Based Complementary and Alternative Medicine, Vol. 6 (Suppl. 1), 2009, pp. 1–3). The main purposes of the present study are to estimate genetic and environmental influences on SC types, and to explore genetic and environmental correlations that affect phenotypic associations among the SC types. In total, 1,742 (365 monozygotic male, 173 dizygotic male, 675 monozygotic female, 271 dizygotic female, and 258 opposite-sex dizygotic) twins (mean age = 19.1 ± 3.1 year) completed a Sasang questionnaire. Univariate and multivariate model-fitting analyses were performed. Total (additive and non-additive) genetic influences were 71% for males and 81% for females in TE, 70% for males and 71% for females in SE, and 47% for both sexes in SY. Non-additive genetic effects were substantial, and shared environmental influences were negligible in most SC types. Multivariate model-fitting analysis revealed that non-additive genetic and individual-specific environmental correlations between TE and SE were -0.92 (95% CI [-0.89, -0.93]) and -0.62 (95% CI [-0.57, -0.68]), respectively. The corresponding estimates were -0.55 (95% CI [-0.48, -0.61]) and -0.44 (95% CI [-0.37, -0.51]) between TE and SY and 0.19 (95% CI [0.09, 0.29]) and -0.40 (95% CI [-0.32, -0.47]) between SE and SY. These results suggest that the phenotypic associations among SC types may be mediated by pleiotropic mechanism of genes.

Euiiyin-tang in the treatment of obesity: study protocol for a randomised controlled trial

Background

Obesity is a public health concern in many countries due to its increasing prevalence. Euiiyin-tang is an herbal medicine formula often used as a clinical treatment for obesity. It acts to eliminate humidity and purify the blood, the causes of obesity identified by the theoretical framework of Korean medicine. The purpose of this study is to evaluate the efficacy and safety of Euiiyin-tang in treating obesity.

Methods/design

This study is a randomised, double-blinded and placebo-controlled, multicentre trial. It has two parallel arms: the Euiiyin-tang group and the placebo group. A total of 160 obese adult women will be enrolled in the trial. The participants will be randomly divided at a 1:1 ratio at visit 2 (baseline). The participants will be administered Euiiyin-tang or placebo for 12 weeks. The primary endpoint is the change in weight occurring between baseline and post-treatment. The secondary outcomes include average weight reduction, changes in body fat, waist and hip circumferences, body mass index, and lipid profile, and the results of questionnaires such as the Korean version of Obesity-related Quality of Life, the Korean version of Eating Attitudes Test, the Social Readjustment Rating Scale, and the Stress Reaction Inventory.

Discussion

The present study will provide research methodologies for evaluating the efficacy and safety of Euiiyin-tang in patients with obesity. In addition, it will provide evidence of correlation between obesity and Sasang constitutional medicine.

Trial registration

ClinicalTrials.gov, NCT01724099. Registered on 2 November 2012.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2039-8) contains supplementary material, which is available to authorized users.

Energy metabolism and whole-exome sequencing-based analysis of Sasang constitution: a pilot study

BACKGROUND

Traditional Korean Sasang constitutional (SC) medicine categorizes individuals into four constitutional types [Tae-eum (TE), So-eum (SE), Tae-yang (TY), or So-yang (SY)] based on biological and physiological characteristics. As these characteristics are closely related to the bioenergetics of the human body, we assessed the correlation between SC type and energy metabolism features.

METHODS

Forty healthy, young (22.3 ± 1.4 years) males volunteered to participate in this study. Participants answered an SC questionnaire, and their face shape, voice tone, and body shape were assessed using an SC analysis tool. Thirty-one participants (10 TE, 10 SE, 3 TY, and 8 SY) were selected for further analysis. Collected blood samples were subjected to blood composition analysis, mitochondrial function analysis, and whole-exome sequencing.

RESULTS

The SY type showed significantly lower total cholesterol and high-density lipoprotein cholesterol levels than the SE type. Cellular and mitochondrial Adenosine triphosphate (ATP) levels were similar across types. All types showed similar basal mitochondrial oxygen consumption rates, whereas the TE type showed a significantly lower ATP-linked oxygen consumption rate than the other types. Whole-exome sequencing identified several genes variants that were exclusively detected in particular SC types, including 19 for SE, seven for SY, 11 for TE, and six for TY.

CONCLUSION

SC type-specific differences in mitochondrial function and gene mutations were detected in a small group of healthy, young Korean males. These results are expected to greatly improve the accurate screening and utilization of SC medicine.

A Systematic Review on Sasang Constitutional Type-Associated Susceptibility to Disorders in Korea

BACKGROUND/OBJECTIVE

Sasang constitutional medicine is a component of traditional Korean medicine that classifies individuals into four Sasang constitutional types (SCTs) by their physical and psychological traits. Each SCT is known to show different susceptibilities to disorders. This systematic review investigated the effect of SCT as a risk factor for various disorders.

METHODS

A systematic literature survey was conducted by searching seven databases for all articles on the prevalence rates of disorders according to SCT and sex.

RESULTS

From 14,272 relevant articles, 15 studies (13 disorders) were ultimately identified to verify different prevalence rates by SCT. Of the 13 disorders, 6 (prehypertension, general obesity, abdominal obesity, metabolic syndrome, diabetes mellitus, and irritable bowel syndrome [IBS]) had a significantly different prevalence by SCT. Metabolic syndrome and its associated disorders showed the highest prevalence in Taeumin-type individuals, whereas IBS was most prevalent in Soeumin-type individuals. In general, these findings were consistent with the results obtained in an analysis of male and female participants.

CONCLUSIONS

This study revealed that susceptibility to disorders was affected by SCT to some extent. Further studies are needed to determine the concrete features of SCT-related susceptibility, which may be helpful in preventive medicine with Sasang constitutional practice.

Beneficial effects of cocoa, coffee, green tea, and garcinia complex supplement on diet induced obesity in rats

Background

Cocoa, coffee, green tea and garcinia contain large amounts of polyphenols. Polyphenols are well-known phytochemicals and found in plants, and have modulated physiological and molecular pathways that are involved in energy metabolism, adiposity, and obesity.

Methods

To evaluate the obesity-lowering effect of a combined extract (comprising cocoa, coffee, green tea and garcinia; CCGG) in high-energy diet (HED)-induced obese rats. Male Sprague Dawley rats (8 weeks old) were randomly divided into four groups (n = 12 per group): normal diet with vehicle treatment (Control), and HED to receive vehicle or CCGG by oral gavage at 129, 258, or 517 mg/kg/day for 4 weeks, designated the HED, 0.5X, 1X and 1X groups, respectively.

Results

HED induced macrovesicular fat in the liver and the formation of adipose tissues, and significantly increased the levels of serum free fatty acids (FFA), triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and LDL-C/HDL-C, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ketone bodies in serum, and hepatic TG and TC levels, and decreased the levels of high density lipoprotein cholesterol (HDL-C) in serum and lipase activity in fat tissues. Treatment with CCGG could significantly decrease the levels of FFA, TG, TC, LDL-C, and LDL-C/HDL-C, AST, ALT, and ketone bodies in serum, and hepatic TG and TC contents, and increase the levels of HDL-C in serum and lipase activity in fat tissues compared to the HED group. Liver histopathology also showed that CCGG could significantly reduce the incidence of liver lesions.

Conclusion

These results suggested that CCGG stimulated lipid metabolism in HED-induced obese rats, which is attributable to fat mobilization from adipose tissue.